tetano
Editor, Senior Moderator
Am J Health Syst Pharm
. 2025 Mar 22:zxaf061.
doi: 10.1093/ajhp/zxaf061. Online ahead of print. Evaluation of pharmacist-prescribed nirmatrelvir/ritonavir for patients with COVID-19
Jason Srey[SUP] 1 [/SUP], Samantha Divan[SUP] 1 [/SUP], Andrew J Sowles[SUP] 2 [/SUP], Michelle Rasmussen[SUP] 2 [/SUP], Ralph A Yates[SUP] 2 [/SUP], Adriane N Irwin[SUP] 3 [/SUP]
Affiliations
Disclaimer: In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.
Purpose: Authorization of nirmatrelvir/ritonavir expanded outpatient treatment options for those with coronavirus disease 2019 (COVID-19), but prescribing of the medication is complex. The objective of this study was to evaluate the appropriateness of nirmatrelvir/ritonavir prescribing through a pharmacist-driven service as compared to usual care.
Methods: This was a retrospective cohort study. Patients prescribed nirmatrelvir/ritonavir by a pharmacist between May 1 and December 31, 2022, were temporally matched to those who received nirmatrelvir/ritonavir through usual care. The primary outcome was the percentage of patients appropriately prescribed nirmatrelvir/ritonavir by meeting criteria related authorization-specific requirements, assessment of hepatic and renal function, and management of drug interactions. Descriptive and inferential statistics were performed.
Results: There were 106 patients in each cohort (N = 212). Patients were mainly female (n = 135, 63.7%) and mainly 65 years of age or older (n = 117, 55.2%). All study-defined criteria for appropriate nirmatrelvir/ritonavir prescribing were met in 88.7% of patients (n = 94) who received care through the pharmacist-driven service, as compared to 41.5% of patients (n = 44) managed through usual care (P < 0.0001). In both groups nirmatrelvir/ritonavir was consistently prescribed within 5 days of symptom onset and to patients with a qualifying comorbid condition (P = 0.498). However, hepatic (P = 0.030) and renal (P = 0.024) laboratory values were more likely to be current when the prescription arose from a pharmacist as opposed to the usual care process. Drug interactions also were more likely to be identified and mitigated by pharmacists (P < 0.0001).
Conclusion: Nirmatrelvir/ritonavir was appropriately prescribed by pharmacists in most cases, demonstrating that pharmacists can support safe and effective use of nirmatrelvir/ritonavir for patients with complex comorbidities and medication regimens.
Keywords: COVID-19 drug treatment; drug interactions; nirmatrelvir; patient care team; pharmacists; pharmacy service.
. 2025 Mar 22:zxaf061.
doi: 10.1093/ajhp/zxaf061. Online ahead of print. Evaluation of pharmacist-prescribed nirmatrelvir/ritonavir for patients with COVID-19
Jason Srey[SUP] 1 [/SUP], Samantha Divan[SUP] 1 [/SUP], Andrew J Sowles[SUP] 2 [/SUP], Michelle Rasmussen[SUP] 2 [/SUP], Ralph A Yates[SUP] 2 [/SUP], Adriane N Irwin[SUP] 3 [/SUP]
Affiliations
- PMID: 40119493
- DOI: 10.1093/ajhp/zxaf061
Disclaimer: In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.
Purpose: Authorization of nirmatrelvir/ritonavir expanded outpatient treatment options for those with coronavirus disease 2019 (COVID-19), but prescribing of the medication is complex. The objective of this study was to evaluate the appropriateness of nirmatrelvir/ritonavir prescribing through a pharmacist-driven service as compared to usual care.
Methods: This was a retrospective cohort study. Patients prescribed nirmatrelvir/ritonavir by a pharmacist between May 1 and December 31, 2022, were temporally matched to those who received nirmatrelvir/ritonavir through usual care. The primary outcome was the percentage of patients appropriately prescribed nirmatrelvir/ritonavir by meeting criteria related authorization-specific requirements, assessment of hepatic and renal function, and management of drug interactions. Descriptive and inferential statistics were performed.
Results: There were 106 patients in each cohort (N = 212). Patients were mainly female (n = 135, 63.7%) and mainly 65 years of age or older (n = 117, 55.2%). All study-defined criteria for appropriate nirmatrelvir/ritonavir prescribing were met in 88.7% of patients (n = 94) who received care through the pharmacist-driven service, as compared to 41.5% of patients (n = 44) managed through usual care (P < 0.0001). In both groups nirmatrelvir/ritonavir was consistently prescribed within 5 days of symptom onset and to patients with a qualifying comorbid condition (P = 0.498). However, hepatic (P = 0.030) and renal (P = 0.024) laboratory values were more likely to be current when the prescription arose from a pharmacist as opposed to the usual care process. Drug interactions also were more likely to be identified and mitigated by pharmacists (P < 0.0001).
Conclusion: Nirmatrelvir/ritonavir was appropriately prescribed by pharmacists in most cases, demonstrating that pharmacists can support safe and effective use of nirmatrelvir/ritonavir for patients with complex comorbidities and medication regimens.
Keywords: COVID-19 drug treatment; drug interactions; nirmatrelvir; patient care team; pharmacists; pharmacy service.